Background <p>Patients with diabetes who are hospitalized in non‑endocrinology departments account for over 90% of all hospitalized patients with diabetes in China, yet their blood glucose management is often suboptimal and overshadowed by their primary diagnoses. The real‑life experiences and unmet needs of this population remain largely unexplored. This study aimed to explore the hidden needs of these patients regarding blood glucose management during hospitalization.</p> Methods <p>This descriptive qualitative study adhered to the Standards for Reporting Qualitative Research (SRQR). Using purposive sampling with maximum variation, we recruited 12 adult patients with diabetes from various non‑endocrinology departments (6 males, 6 females; age range 30–81 years; all type 2 except one with pregestational diabetes mellitus (PGDM)). The interview guide was informed by the COM‑B model (Capability, Opportunity, Motivation). Data were analyzed using inductive qualitative content analysis.</p> Results <p>Four main categories were identified: (1) Conflict between primary diagnosis and diabetes, (2) confusion regarding systematic blood glucose management, (3) barriers to self-management, and (4) the extra burdens. Collectively, these factors constitute hidden needs that remain inadequately identified and addressed within conventional specialty care pathways.</p> Conclusions <p>Patients with diabetes in non-endocrinology departments experience profound hidden needs that are intertwined with their primary diagnoses and are routinely overlooked in current specialty focused care. Optimized management strategies must transcend mere blood glucose monitoring and medication adjustments, shifting toward patient-centered integrated care models. This requires systematic attention to response for patients’ economic and psychosocial needs, thereby effectively enhancing management outcomes and improving patient experience.</p>